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Langenbeck's Archives of Surgery

, Volume 401, Issue 8, pp 1191–1201 | Cite as

Quality of life and need for care in patients with an ostomy: a survey of 2647 patients of the Berlin OStomy-Study (BOSS)

  • Chris Braumann
  • Verena Müller
  • Moritz Knies
  • Birgit Aufmesser
  • Wolfgang Schwenk
  • Gerold KoplinEmail author
ORIGINAL ARTICLE

Abstract

Background

Although ostomies are sometimes necessary, it is unclear which type of ostomy is advantageous for quality of life (QoL). In an observational study of 2647 patients, QoL after colostomy (CS) and small bowel stoma (SBS) formation was evaluated.

Methods

The European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30 and CR-38 questionnaires were used. Patient characteristics, retrospective information about the ostomy and previous treatments, and current stoma-related complications were recorded. All questionnaires were distributed and collected by stoma therapists at the homecare company PubliCare®.

Results

In all, 1790 patients had a CS, and 756 had an SBS. The mean Global Health Score (mGHS—a general QoL indicator) was 52.33 in CS and 49.40 in SBS patients (p = 0.004), but the effect size (Cohen’s d) was 0.1. In SBS patients, all functional scores were lower and most of the symptom scores were higher.

Conclusions

QoL differed significantly for CS and SBS patients, but the effect size was marginal. The care of certain patient groups, particularly (female) patients who receive emergency surgeries, must be improved. More professional education and guidance are necessary for a larger proportion of patients. This survey provided reference data for quality of life in patients with an ostomy.

Keywords

Quality of life Surgery Ostomy, EORTC 

Notes

Acknowledgments

The company PubliCare®, located in Cologne, Germany, supported this study by contacting the patients and collecting the data.

Compliance with ethical standards

The Declaration of Helsinki was observed, and consent was obtained from all patients.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Holzel D (2003) Quality of life in rectal cancer patients: a four-year prospective study. Ann Surg 238:203–213PubMedPubMedCentralGoogle Scholar
  2. 2.
    Jain S, McGory ML, Ko CY, et al. (2007) Comorbidities play a larger role in predicting health-related quality of life compared to having an ostomy. Am J Surg 194:774–779 discussion 9CrossRefPubMedGoogle Scholar
  3. 3.
    Pachler J, Wille-Jorgensen P (2012) Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 12:CD004323PubMedGoogle Scholar
  4. 4.
    Popek S, Grant M, Gemmill R, et al. (2010) Overcoming challenges: life with an ostomy. Am J Surg 200:640–645CrossRefPubMedGoogle Scholar
  5. 5.
    Vermeulen J, Gosselink MP, Busschbach JJ, Lange JF (2010) Avoiding or reversing Hartmann’s procedure provides improved quality of life after perforated diverticulitis. J Gastrointest Surg 14:651–657CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Mahjoubi B, Kiani Goodarzi K, Mohammad-Sadeghi H (2010) Quality of life in stoma patients: appropriate and inappropriate stoma sites. World J Surg 34:147–152CrossRefPubMedGoogle Scholar
  7. 7.
    Marquis P, Marrel A, Jambon B (2003) Quality of life in patients with stomas: the Montreux Study. Ostomy Wound Manage 49:48–55PubMedGoogle Scholar
  8. 8.
    Aaronson NK, Ahmedzai S, Bergman B, et al. (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMedGoogle Scholar
  9. 9.
    McLachlan SA, Devins GM, Goodwin PJ (1998) Validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) as a measure of psychosocial function in breast cancer patients. Eur J Cancer 34:510–517CrossRefPubMedGoogle Scholar
  10. 10.
    Osoba D, Aaronson N, Zee B, Sprangers M, te Velde A (1997) Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. The Study Group on Quality of Life of the EORTC and the Symptom Control and Quality of Life Committees of the NCI of Canada Clinical Trials Group. Qual Life Res Int J Qual Life Asp Treat Care Rehab 6:103–108Google Scholar
  11. 11.
    Cull AM (1997) Cancer-specific quality of life questionnaires: the state of the art in Europe. Eur J Cancer 33(Suppl 6):S3–S7CrossRefPubMedGoogle Scholar
  12. 12.
    Sprangers MA, te Velde A, Aaronson NK (1999) The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life. Eur J Cancer 35:238–247CrossRefPubMedGoogle Scholar
  13. 13.
    Fayers PM (2001) Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30. Eur J Cancer 37:1331–1334CrossRefPubMedGoogle Scholar
  14. 14.
    Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 37:1345–1351CrossRefPubMedGoogle Scholar
  15. 15.
    Cottam J, Richards K, Hasted A, Blackman A (2007) Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Dis 9:834–838CrossRefPubMedGoogle Scholar
  16. 16.
    Pengelly S, Reader J, Jones A, Roper K, Douie WJ, Lambert AW (2014) Methods for siting emergency stomas in the absence of a stoma therapist. Ann R Coll Surg Engl 96:216–218CrossRefPubMedGoogle Scholar
  17. 17.
    Shabbir J, Britton DC (2010) Stoma complications: a literature overview. Colorectal Dis 12:958–964CrossRefPubMedGoogle Scholar
  18. 18.
    Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol Off J Am Soc Clin Oncol 16:139–144Google Scholar
  19. 19.
    Guenaga KF, Lustosa SA, Saad SS, Saconato H, Matos D (2007) Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev CD004647Google Scholar
  20. 20.
    Tilney HS, Sains PS, Lovegrove RE, Reese GE, Heriot AG, Tekkis PP (2007) Comparison of outcomes following ileostomy versus colostomy for defunctioning colorectal anastomoses. World J Surg 31:1142–1151CrossRefPubMedGoogle Scholar
  21. 21.
    Karadag A, Mentes BB, Uner A, Irkorucu O, Ayaz S, Ozkan S (2003) Impact of stomatherapy on quality of life in patients with permanent colostomies or ileostomies. Int J Color Dis 18:234–238Google Scholar
  22. 22.
    Watson PG (1983) The effects of short-term postoperative counseling on cancer/ostomy patients. Cancer Nurs 6:21–29CrossRefPubMedGoogle Scholar
  23. 23.
    Herlufsen P, Olsen AG, Carlsen B, et al. (2006) Study of peristomal skin disorders in patients with permanent stomas. Br J Nurs 15:854–862CrossRefPubMedGoogle Scholar
  24. 24.
    Erwin-Toth P, Thompson SJ, Davis JS (2012) Factors impacting the quality of life of people with an ostomy in North America: results from the dialogue study. J Wound Ostomy Continence Nurs 39:417–422 quiz 23-4CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of General- and Visceral Surgery St. Josef HospitalRuhr University of BochumBochumGermany
  2. 2.Department of General, Visceral, Vascular and Thoracic SurgeryCharité - University Medicine BerlinBerlinGermany
  3. 3.Department of General, Visceral and Transplantation SurgeryCharité - University Medicine BerlinBerlinGermany
  4. 4.Department of General and Visceral Surgery, MISAsklepios Klinik AltonaHamburgGermany

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